摘要
目的观察经鼻高流量湿化氧疗(high-flow nasal cannula oxygen therapy,HFNC)辅助治疗慢性阻塞性肺疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)的临床疗效。方法选取2022年3月-2024年3月住院治疗的100例AECOPD患者作为研究对象,随机分为观察组和对照组,每组各50例,均给予常规抗感染、镇咳化痰、解痉平喘等治疗。在常规治疗的基础上,观察组给予HFNC辅助治疗,对照组给予鼻导管吸氧治疗。记录患者在治疗24、48 h后的mMRC评分,检测血气分析数据及血清IL-6、IFN-γ、TNF-α水平。治疗2周后复查患者的肺功能。结果最终共有92例患者完成研究,其中观察组47例,对照组45例。治疗48 h后,观察组的mMRC评分显著低于对照组(P<0.05),两组的氧分压(partial pressure of oxygen,PaO 2)和血氧饱和度(pulse oxygen saturation,SpO 2)均有升高,但是组间差异无统计学意义(P>0.05),观察组PaCO 2低于对照组(P<0.05)。与对照组相比,观察组患者血清IL-6、IFN-γ及TNF-α水平均下降(P<0.05)。治疗2周后,观察组的肺功能指标,包括用力肺活量(forced vital capacity,FVC)、第一秒用力呼气容积(forced expiratory volume in the first second,FEV 1)和FEV 1/FVC均显著改善(P<0.05)。结论HFNC辅助治疗能够有效减轻AECOPD患者的呼吸困难,缓解炎症反应,改善氧合及肺功能。
Objective To assess the therapeutic efficacy of high-flow nasal cannula oxygen therapy(HFNC)in treating acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods This study included 100 hospitalized patients with AECOPD treated from March 2022 to March 2024.The patients were randomly allocated into the observation group and control group,with 50 cases in each group.All patients received conventional treatments including anti-infection therapy,antitussive and expectorant treatment,as well as spasmolysis and antiasthmatic therapy.Based on routine treatment,observation group was given HFNC therapy,while the control group received nasal cannula oxygen therapy.The modified Medical Research Council(mMRC)score,blood gas analysis and serum interleukin(IL)-6,interferon(IFN)-γand tumor necrosis factor(TNF)-αwere checked at 24 and 48 hours after the treatment.The pulmonary function-related parameters were re-assessed two weeks later.Results Finally,92 patients completed the study,including 47 in the observation group and 45 in the control group.At 48 hours following treatment,the mMRC score in the observation group was significantly lower than that in the control group(P<0.05);both groups showed increased levels of partial pressure of oxygen(PaO 2)and pulse oxygen saturation(SpO 2),but there was no statistical difference between the two groups(both P>0.05).Compared with the control group,the observation group exhibited lower partial pressure of carbon dioxide(PaCO 2)level and reduced levels of serum IL-6,IFN-γand TNF-α(all P<0.05).Two weeks of treatment later,compared to the control group,the observation group demonstrated significant improvements in forced vital capacity(FVC),forced expiratory volume in the first second(FEV 1)and FEV 1/FVC(all P<0.05).Conclusion HFNC effectively alleviates dyspnea in AECOPD patients,relieves inflammatory reaction,improves oxygenation and pulmonary function.
作者
骆金旺
许东晴
陈占军
嵇华夏
郑永华
LUO Jinwang;XU Dongqing;CHEN Zhanjun;JI Huaxia;ZHENG Yonghua(Tinglin Community Health Service Center,Jinshan District,Shanghai 201504,China;Department of Respiratory Medicine,Tinglin Hospital,Jinshan District,Shanghai 201505,China)
出处
《同济大学学报(医学版)》
2025年第4期588-592,共5页
Journal of Tongji University(Medical Science)
基金
上海市“科技创新行动计划”自然科学基金项目(23ZR1454500)。
关键词
慢性阻塞性肺疾病急性加重
经鼻高流量湿化氧疗
mMRC评分
肺功能
acute exacerbation of chronic obstructive pulmonary disease
high-flow nasal cannula
modified Medical Research Council score
pulmonary function
